Merchants

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Merchant ID

Legal Name

DBA Name

Processor

Agent

Split

Is Override

Password

Received Date

Approved Date

Activation Date

Closed Date

Product Type

Status

Address

Address 2

City

ZIP

Country

State

Contact

Email(comma separated)

Phone

Phone 2

Cell

Fax

URL

DBA Same as Legal Address

Address

City

ZIP

Country

State

Mailing Address Same as DBA

Address

City

ZIP

Country

State

File here *	Download	Notes *	Status	Date
		pre app
		voided check

Type

Install Date

Equipment ID

Status

Model

Purchase T.

PD Telephone

Sales Rep

Serial #

Tracking #

TID

Employee

Purchase Date

Type

Install Date

Equipment ID

Status

Model

Purchase T.

PD Telephone

Sales Rep

Serial #

Tracking #

TID

Employee

Purchase Date

Send Email to Merchant Send Email to Sales rep Send Email to Employee

Bank 1 Information

Bank Name

Account Name

Rounting Number

Account Number

Billing Type

Gross Settlement

Net Settlement

Bank 2 Information

Bank Name

Account Name

Rounting Number

Account Number

Overrides who receive partial commission on all of Deurali Group LLC Accounts

Default Setup

Agent 1 Receives

%

on all Newly Inputted Accounts

Agent 2 Receives

%

on all Newly Inputted Accounts

Agent 3 Receives

%

on all Newly Inputted Accounts

Agent 4 Receives

%

on all Newly Inputted Accounts

Processor wise Setup

Select Processor *

Agent 1 Receives

%

on all Newly Inputted Accounts

Agent 2 Receives

%

on all Newly Inputted Accounts

Agent 3 Receives

%

on all Newly Inputted Accounts

Agent 4 Receives

%

on all Newly Inputted Accounts

Select Processor *

Agent 1 Receives

%

on all Newly Inputted Accounts

Agent 2 Receives

%

on all Newly Inputted Accounts

Agent 3 Receives

%

on all Newly Inputted Accounts

Agent 4 Receives

%

on all Newly Inputted Accounts

Merchant *

Month *

Year *

Merchant CMS

EIN/Federal Tax ID Type

MCC Code

EIN/Federal Tax ID #

Type of Legal Entity

State incorporated in

Types of Goods Sold

Primary Transaction Type

Internet

%

Swipe

%

Keyed

%

Average Ticket

Telephone Order

%

Annual Volume

Business Start Date

High Ticket

Persoanl Guarantor

Monthly Volume

Discount Method

Refund Policy

30 Days

60 Days

Other

None

Date

Reminder Date & Time

Employee

Notes

Sr. No.	Date	Reminder Date	Employee	Note	Action
1	Aug 01 2023		Morgan Withee	User: Morgan Withee -> Notes: Merchant has been opted in on Access One and welcome email sent to [email protected] temp pwd Q5e[DqVzF
2	Aug 01 2023		Morgan Withee	User: Morgan Withee -> Notes: Needs access to access one I put in ticket in iris will update ash when its completed
3	Aug 01 2023		Morgan Withee	User: Morgan Withee -> Notes: Spoke with Stuart the pump vendor most of the day. They are still getting error 4R they are saying that's wrong encryption. I also found out it could be an emv issue. I gave Stuart a list of all encryptions that can be used. And also suggested they update the software on their pumps. he is going to get with the merchant and then call me back.
4	Aug 01 2023		Morgan Withee	User: Morgan Withee -> Notes: Fuel pump vendor called in to check to see if everything had been updated. I let him know everything was updated and to call back if he had any issues.
5	Aug 01 2023		Mike Thomas	User: Mike Thomas -> Notes: Sent Ash a text on Tuesday 6/29/21 to let him know it has been updated...I also called and talked to him today. He has reached out to the merchant already to let him know he can schedule pump vendor.
6	Aug 01 2023		Mike Thomas	User: Mike Thomas -> Notes: TT Steve at Rev 19 he says encryptions have been updated but was going to call us in the morning as it takes 24 hours to refresh at First Data. I've tried to call Ash to update him but he's not answering and voicemail isn't set up.
7	Aug 01 2023		Mike Thomas	User: Mike Thomas -> Notes: I've called Rev19 to try to get the encryptions to match with old and new accounts. One does match (Wells NA SPON-BUY TD351) but the other doesn't old has Wells NA Legacy SPON TD300 and the new has Carltn NA BUY TD501. When I called Rev 19 that said they only have one person (Steve) that does the encryptions and he's on vacation. They also said they emailed deployment and they would email me an answer as to whether or not they have the Legacy encryption. I asked to speak to that person and they told me he doesn't have a phone.
8	Aug 01 2023		Kamal Oghad	User: Kamal Oghad -> Notes: Rev 19 Traditional Terminal ID: L351682531001 Buypass ID: 682531
9	Aug 01 2023		Kamal Oghad	User: Kamal Oghad -> Changed : AnnualVolume FROM 0 TO 1300000

Application Type

Discount

Business Type

MCC Code

Visa/MC/Discover Rate Category

Base/Qualified (%)

Mid Qualified (%)

Non Qualified (%)

Base Debit- Non Pin Debit(Sig Debit Rate) (%)

Rewards Discount (%)

Statement Fee

Card On File Fee

PCI Fee

Non PCI Compliance

Authorization Fee

Per Item Fee

EBT Fee

FNS/EBT Number

Pin Debit Item Fee

Pin Debit Discount

Amex Opt Blue Rate

Base/Qualified Rate (%)

Mid Qualified Rate (%)

Non Qualified Rate (%)

Program Cost Opt Blue (%)

Authorization Fee

Per Item Fee

Other Monthly Fee

Ancillary Fees

Batch Fee

Retrievel Fee

Chargeback Fee

ACH Change Fee

Voice Auth Fee

Gateway Monthly Fee

Setup Fee

Owner 1 Information

Officer/Owners Name

Title

Social Security

Form of ID

ID #

Issue Date

Expiration Date

State

DOB

Home Phone Number

% of Business Owned

Length of Ownership

Y N

Home Address

Home city

Home state

Home country

Home zip

Owner 1 Information

Officer/Owners Name *

Title

Social Security

Form of ID *

ID # *

Issue Date *

Expiration Date *

State *

DOB *

Home Phone Number

% of Business Owned

Length of Ownership

Y N

Home Address *

Home city *

Home state *

Home country

Home zip *

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